Acid base balance of the respiratory acidosis and alkalosis

1. R J A K A S H S P E A K E R
ACID BASE BLANCE FOR RESPIRAY AND MEATABOLIC ACIDOSIS

2. ACID BASE BLANCE
Normal aterial blood gas values SI unit laboratry test conventional
unit
Arterial PH (arterial) 7.35-7.45
Pao2 is value 35-45 MM of hg
Bicarbonate (HCO3-) 21-28 MeqL & MMOLL
Pao2 80-100 mm of hg
Venous - 7.31 -7.41
PVO2- 40-50 mm of hg

3. RESPIRATORY ALKALOSIS -
PH INCREASE - PCO2 DECREASE K+ DECREASE
RESPIRATORY ACIDOSIS -
PH DECREASE , INCREASE PCO2 K+ INCREASE
METABOLIC ACIDOSIS -
PH DECREASE PCO2 DECREASE
METABOLIC ALKALOSIS - INCREASE PH PCO2 INCREASE

4. A fluid volume is excess is also known as overhydration or fluid
over load and occurs when fluid intake or fluid retention exceed
the fluid needs of the body.assessement finding associated
with fluid volume excess include cough , dyspnea, crackles,
elevated CVP , weight gain ,edema, neck and hand distention ,
altered level of consiousness, and decreased hematocrit.
dry skin ,flat neck and hand veins, decresased urinary output,
and decreased CVP are noted in fluid volume deficite .
Weakness can be present in the either fluid volume excess or
deficite.

5. The normal serum potassium level is 3.5 to 5.0 meqL (3.5 to 5.0
mmolL).
A potassium deficit is known as hypokalemia. potassium rich
gastrointestional fluids are lost through gastrointestional fluids are
lost through gastrointestional suction , placing the client at risk for
hypokalemia. the client with tissue damage or Addition’s disease &
the client with hyperuricemia are at risk for hyperkalemia.
The normal uric acid level for female is 2.7 & 7.3 mgdl
(160 to 430 mcmolL) and for a male is 4.0 to 8.5 mgdl
(240 to 501 mcmolL).

6. The normal serum potassium level is 3.5 to 5.0 meqL (3.5-5.0 mmolL)
A serum pottassium level lower than 3.5 meqL indicates hypokalemia.
Potassium deficit is an electrolyte imblance that can be potentially life
threatening life threatening. Electrocardiographic changes include
shallow, flat, or inveted T waves; ST segment depression; and
prominant U waves. absent P WAVES. absent P wave are not a
charaterstics of hypokalamia but may noted in a client with arterial
fibrillation arterial fibrillation , junctionalal rhythms. or ventricular
rhythms. A widened QRS complex may be noted in hyperkalemia and
hypermagnesemia.

7. Pottassium chloride administered intervenously must be always be
diluted in IV fluid and infused via an infusion pump.
pottassium chloride is never given by bolous (IV PUSH).
Giving pottasium choride by IV push can result in cardiac arrest.
the nurse should be ensure that the potassium diluted in the
appopriate amount of diluted or fluid.
The IV BAG contining the pottasium chloride should always be labeled
with the voulme of pottassium it contains. The IV site is monitered
closely, because potassium chloride is irritating the veins and there is
risk of phlebitis. in addition , the nurse monitirs urinary output during
adminitration and contacts the primary health care provider if the
urinary output is less than 30 mlhr.

8. A client with lacose intoerance is at risk for developing hypocalcemia ,
because food products that contain calcium also contain lactose . the
normal serum calcium level is 9 to 10.5 mgdl (2.25 to 2.75 mmolL)
A serum calcium level lower than 9 mgdl (2.25 mmol) indicates
hypocalcimia. Signs of hypocalcimia including paresthesis followed by
numbness, hyperactive deep tendon reflexes and positive TROUSSEAU’S
or Chvostek’s sign.
Additional signs of hypocalcimia include increased neuromuscular
exitibility ,muscle cramps , twiching, tetany, seizures, irritability and
anxity. Gastrointestinal symptoms include increase gastric motility,
hyper active bowel sounds, abdominal cramping, and diarrhea.

9. A client with crohn’s disease is at risk for hypocalcimia. The normal
serum calcium level is 9 to 10.5 mgdl (2.25 to 2.75 mmoll).
A serum calcium level lower than 9 mgdl (2.25 mmoll) indicates
hypocalcimia .electrocardiograpic changes that occur in the client
with hypocalcemia include a prolonged QT intervel and prolonged ST
segment and widened T wawe occur with hypercalcimia. ST
depression and prominent U waves occurs with hypokalemia .ST
depression and prominant U wave occur with hypokalemia.
crohn’s disease who has a calcium level of 8 mgdl (2mmoll).
it is necessary to recall the electrocardiographic changes that occur
in hypocalcemia causes a prolonged ST segment and prolonged QT
intervel.

10. The client with chronic kidney disease is at risk for
hyperkalemia. The normal potassium level is 3.5-5.0
meqL (3.5 to 5.0 mmoll)
a serum pottasium level is 3.5 to 5.0 greater than 5.0
meql (5.0 mmoll) indicates hyperkalemia. Electrograpic
changes associated with hyperkalemia include flat P
waves, prolonged PR intervels, widened QRS complexs
and tall peaked T waves , flat P waves. widened QRS
complexes, and prolonged PR interval are associated
with hyperkalemia.

11. *The normal serum sodium level is 135 to 145 meqL (135 to
145mmolL) Hyponatremia is evidenced by a serum sodium level lower
than 135 meqL (135 mmolL ) hyperactive bowel sound indicate
hyponatremia . The remening option are signs of hypernatremia in
hyponatremia , muscle weakness . increase urinary output ,and
decreased specific gravity of the urine would be noted.
*The normal serum phosphoras (phosphate) level is 3.0 -4.5 mg dl (0.97
to 1.45 mmmoll) .The client experiencing hypophosphatemia.
Causative factors relete to malnutrition or starvation and the use of
aluminium hydroxide based or magnesium based anatacid .
renal insufficiency, hypoperathyroidism , and tumor lysis syndrome are
causitive factor of hyperphosphatemia

12. C O N T E N T S
01. ACID BASE BLANCE
02. NCLEX BASED QUESTIONS
03.
04.
T H E O R Y P R A C T I C E
S U M M A R Y

13. T H A N K YO U
Student Science and Technology Exhibition